Health Insurance Mandates

Sam Stein reports that “Democrats are bracing themselves for a new line of conservative attack against a provision in the health care legislation once considered so non-controversial that it was endorsed by several major Republican officials.” What is it, you might ask, that these dastardly Republicans are opposing out of their racist hatred of Barack Obama?

On Tuesday, Sen. Jon Kyl (R-Ariz.) described the health care legislation being considered by the Senate Finance Committee as a “stunning assault on liberty” due to a provision that would require individuals to buy insurance. Earlier in the week, the individual mandate also came under attack when Tim Phillips, who heads Americans for Prosperity, described it as an assault on individual liberty. “When you have health care, that’s a choice that impacts yourself,” Phillips told MSNBC’s Hardball. “Drivers’ insurance impacts other drivers you may have accidents with.”

The attacks have confounded Democrats in and out of government, who noted quickly that mandating coverage was, until recently, a relative given when it came to health care reform. “It’s f–ing ludicrous,” said one health care reform activist, who noted that when Finance Committee Chairman Max Baucus (D-Mont.) asked committee members to air their disagreements with an individual mandate during a meeting on May 5, no one chimed in.

Indeed, for months it was presumed that a relatively ironclad deal was in place: in exchange for the government mandating coverage, private insurance companies would agree to cover individuals with pre-existing conditions. The arrangement was all but blessed by prominent figures from within the GOP ranks. In mid-August, the ranking member of the finance committee, Sen. Chuck Grassley (R-Iowa), announced that the way to get universal coverage is “through an individual mandate.” “That’s individual responsibility,” the senator told Nightly Business Report. “And even Republicans believe in individual responsibility.”

So, Chuck Grassley and at least six other Republicans currently in the Senate support — or at least are willing to sign off on — a law forcing Americans to buy health insurance. But that hardly renders it “non-controversial.”

Indeed, this provision was incredibly controversial during last year’s Democratic presidential primaries. Indeed, only John Edwards and Hillary Clinton supported mandates. Among those opposing? Barack Obama and Joe Biden who, as some will recall, went on to win the presidential and vice-presidential nominations, respectively, of the Democratic Party and go on to win election to those offices.

Obama’s health care plan, which he announced last week, has been widely criticized by liberals for not making health insurance mandatory. Challenged by Edwards, Obama explained why a mandate is not a cure-all. “If you look at auto insurance, in California there’s mandatory auto insurance,” Obama explained. “Twenty-five percent of the folks don’t have it. The reason is because they can’t afford it. So John and I, we’re not that different in this sense; that I’m committed to starting the process. Everybody who wants it can buy it and it’s affordable. If we have some gaps remaining, we will work on that. You take it from the opposite direction, but you’re still going to have some folks who aren’t insured under your plan, John, because some of them will simply not be able to afford to buy the coverage they’re offered.”

Ron Chusid summarizes the intra-liberal debate on the subject in Liberal Values, February 2008

Paul Krugman continues his vendetta against Barack Obama’s health care plan due to its lack of mandates. The consequence of lacking mandates is unclear as nobody knows for sure how many people would still go without insurance if it was affordable but voluntary, and nobody really knows for sure how many people would remain uninsured despite mandates. It does seem reasonable to assume that achieving near one hundred percent compliance with a mandate would require yet another new bureaucracy and the expenditure of funds which might better be used for actual health care.

There are a variety of views as to whose plan would really insure more people. Robert Reich has argued that more people would wind up being covered under Obama’s plan than Clinton’s.

[...]

Using mandates to achieve universal coverage seems like quite a cop out to me. Regardless of whether the plan is good or the plan stinks, universal coverage is achieved because the government forces you to join up. In contrast Obama takes on the challenge of offering a plan so good that virtually everyone will want to participate to receive health coverage. There is also a clear philosophical difference here in that Obama isn’t obsessed with having every single person sign up. In contrast, a self-proclaimed government junkie like Hillary Clinton just can not live with the fact that somewhere, someone decides they do not want her help. Clinton will help them whether they want her to or not.

I know Clinton supporters will scream that I’m using right wing frames here, but again I must point out that freedom and choice should be considered virtues, not right wing frames. Liberty is what liberalism is ultimately all about, which explains whey Clinton prefers to label herself a progressive and not a liberal.

Some on the far left claim that Democrats lose when these alleged right wing frames about freedom are employed. They got it all wrong. Democrats lose when they concede traditional liberal values such as liberty to the right. If an election is framed so that one side is allowed to be defined as the party of freedom, that party will win virtually every time. Democrats have lost so many elections not because of using right wing frames, but because of conceding values such as freedom to conservatives, even though conservatives talk about freedom without really supporting it.

Ryan Lizza explains why Biden agreed to be Obama’s running mate for The New Yorker in October 2008:

Biden was impressed that Obama’s proposals seemed to be written with an eye toward passage in Congress. (For instance, the lack of a mandate in Obama’s health-care proposal could make the idea more palatable to Republicans.) During the primaries, Biden often played the role of policy grownup, the candidate who liked to chide the unrealistic plans of his rivals.

On July 17th, PoliFact’s Truth-o-Meter awards Obama a full-on flip flop on the issue:

Walk back with us through the mists of time to early 2008, and you might remember then-candidate Barack Obama defending the rights of hard-working people so they would not be forced to buy health insurance.

Obama’s position was different from his two nearest rivals, Hillary Clinton and John Edwards, who included mandates for individuals to buy health insurance in their plans for reform. It was an issue that got downright contentious on the campaign trail.

At a debate in South Carolina, Edwards said Obama’s plan really wasn’t universal health care, since it didn’t have a mandate to ensure everyone was covered.

Obama replied that his plan was universal (a claim we rated Barely True ) and explained why he was against a mandate: “A mandate means that in some fashion, everybody will be forced to buy health insurance. … But I believe the problem is not that folks are trying to avoid getting health care. The problem is they can’t afford it. And that’s why my plan emphasizes lowering costs.”

Obama said at the time it was possible some people would refuse to buy health care under his plan.

“It’s true that some people could game the system by just waiting till they get sick and then they show up,” Obama said. “But keep in mind that my plan also says children will be able to stay on their parents’ plan up until the age of 25. And so I don’t believe that there are a whole bunch of folks out there that will not get coverage. And John, both you and Hillary have a hardship exemption where, if people can’t afford to buy health care, you exempt them so that you sort of don’t count them.”

Now, I don’t much care about the flip-flop. The debate has moved over the past two years, as has the political make-up of the Congress. Obama may well have been legitimately persuaded that his best chance of getting what he wants it to accede to a mandate.

But let’s not rewrite history, either. Forcing Americans to buy health insurance regardless of whether they want it or can afford it is extremely controversial, with not only Republicans but most of the Democratic contenders for the presidency in 2008 opposing it.

UPDATE: Headline of the Day honors go to Bill Quick for “Mandating Change Without Hope.”

Comments

Does anybody know what the means of enforcing the mandate would be? Around here, the car insurance mandate was enforced if you got stopped for a traffic offense. Now, you need to provide an insurance policy number for annual car registration. In my experience people don’t comply with laws that have no apparent enforcement mechanism.

Individual mandates are used around the world in countries using a Bismark type medical insurance system. They’re the only way of gettilng the insurance industry to drop its policies on pre-existing conditions and rescissions. Everybody knows this. It’s clear at this point that the Republican party has no interest in expanding medical insurance coverage, a position it shares with Dr. Joyner. I’m sorry to see this, but facts are facts. Given the choice between the status quo and the very conservative bill originally presented by Senator Baucus, conservatives prefer the status quo.

One way would be to get the tax system to promote enforcement. You could require that people attach a policy number or the like when they file their taxes, along with a history if they’ve switched policies within the past year.

You could also bribe the states to enforce it as well (and since Massachusetts can get away with an individual mandate without constitutional challenge, I don’t see why any other states couldn’t impose a mandate). Do the same thing as the federal government did when promoting the “drinking age at 21″ limit – tie federal funds to the states imposing an individual mandate to buy insurance. After that, there are a whole host of enforcement mechanisms at the state level.

My guess is that we’d see a combination of the two, with the latter being dominant.

If people are forced to buy health insurance can we also include a mandate that fat people lose weight? How about smokers? Can we force them to quit? This is why individual liberty must be defended. The slippery slope is real.

I remember having a smart, excellent employee for several years who would automatically withdraw every dollar put into her retirement account (an amount equal to 15% of her salary). She had done the calculation that the tax and penalty on the early withdrawal (probably around 50%) was less than her immediate needs (caring for her children abandoned by a dead-beat dad).

I expect that is what we’re marching towards. The plan is to increase the cost of health care insurance premiums, so fewer people can afford it, but we’ll reduce the slide with mandates and penalties. The result will be increased inequity.

The term “Bismarck system” is usually used in contrast to the “Beveridge system”. The difference is that in a Bismarck system while insurance may be socialized the service providers remain private while in a Beveridge system (Britain, Italy) a substantial number of providers are public employees.

I share Steve’s concerns about the slippery slope, although in this nightmare scenario, I see more right-wingers coming down on smokers and overweight people than left-wingers. The Tea Party signs about “paying my neighbor’s mortgage” can easily be changed to “paying for my neighbor’s lung cancer treatments.”

I also worry about the enforcement mechanism PD Shaw brings up. Will there be fines and possible jailtime if you don’t buy insurance? (That’s how it is here in CO when it comes to car insurance.)

But I think the main argument (among many) is that mandates will do nothing to control costs and much to exacerbate them.

It’s a solution that does not fix the problem. And therefore it should not be implemented.

Another case where I’m surprised at the surprise. There’s no particular dishonesty involved. When you have limited resources you attack one target at a time.

Should the Axis have been surprised when the Allies, having occupied Sicily, went on to Rome? Of course not and I doubt that Congressional Democrats are actually surprised that Republican have opened up a new front in their opposition to healthcare reform, either.

I do suspect they’re eager to paint the opposition as hypocritical and if they can make it stick more power to them.

[...] Health Insurance Mandates So, Chuck Grassley and at least six other Republicans currently in the Senate support — or at least are willing to sign off on — a law forcing Americans to buy health insurance. But that hardly renders it “non-controversial.â€ [...]

[...] James Joyner writes about the new GOP opposition to mandates that I posted about yesterday. He links to a blast from the 2008 primary past by Ron Chusid defending then candidate Obama’s opposition to mandates: Using mandates to achieve universal coverage seems like quite a cop out to me. Regardless of whether the plan is good or the plan stinks, universal coverage is achieved because the government forces you to join up. In contrast Obama takes on the challenge of offering a plan so good that virtually everyone will want to participate to receive health coverage. . . . In contrast, a self-proclaimed government junkie like Hillary Clinton just can not live with the fact that somewhere, someone decides they do not want her help. Clinton will help them whether they want her to or not. [...]

I sort of knew what a Bismarck system was, I just can’t resist the opportunity when people do Euro-comparisons to point out that European countries don’t maintain or promote with tax breaks the inequitable employer-based system.

First, the claims that it is an assualt on liberty are simply put quite true. It is a state mandate–i.e. you have no choice. Now, it maybe a good policy from the perspective of getting health care costs under control and increasing coverage (or not), but there should be no doubt that this isn’t an assault on one’s ability to choose and make decisions.

As for Plunk’s concern about the slippery slope, in England smokers are denied care until they quit. Here in the U.S. drug users are denied organ transplants–even medical marijuana users. So yes, the slope is real and it is slippery.

Brett, using the tax system would have the benefit of allowing a loophole for the less-well-off, who don’t file tax returns.

Heh, well PD the obvious solution is to have these people file tax returns now. Nevermind that this would be a large cost that wouldn’t show up in the administrative costs for health care. See how we can get those loooow administrative costs? Cool, eh? You think Wall Street has funky accounting. Some people are such idiots.

Herb,

I share Steve’s concerns about the slippery slope, although in this nightmare scenario, I see more right-wingers coming down on smokers and overweight people than left-wingers. The Tea Party signs about “paying my neighbor’s mortgage” can easily be changed to “paying for my neighbor’s lung cancer treatments.”

Bravo! Now, think about the next time a Republican gets into the Presidency and they have both the House and the Senate….

I see this problem and think, we need to keep politicians out of this as much as possible. Funny how the Left thinks, “We need to get them involved even more, but we have to make sure we have just the right politicians!” I think such thinking by the Left is completely daft.

I also worry about the enforcement mechanism PD Shaw brings up. Will there be fines and possible jailtime if you don’t buy insurance? (That’s how it is here in CO when it comes to car insurance.)

Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Just like with not paying taxes. Back payments, fees, interest, penalties. Property foreiture, jail time, wage garnishment. The whole works. Ruin their lives much like the IRS would do now. That they are possibly dying on top it…why that’s just gravy. [/sarcasm]

There were some parts of the bills that I was against. But this is not one of them.

They claim that it is an assault to liberty to force people that can afford health-care to have one. I think it is an assault on my pocket when my tax dollars are used to pay for a person that could afford insurance but chose not to have it. Why should I be a sucker and pay for his hospital bill when he could have bought insurance?

The public option is gone. Therefore, this bill needs to be killed. Enforcing people to buy insurance, forcing insurance companies to cover higher risk people (pre-existing conditions) etc, would skyrocket our premiums. Either have bill with Public option or other forms of competitive measures, or kill it…

They claim that it is an assault to liberty to force people that can afford health-care to have one. I think it is an assault on my pocket when my tax dollars are used to pay for a person that could afford insurance but chose not to have it. Why should I be a sucker and pay for his hospital bill when he could have bought insurance?

See, two wrongs do make a right! Or two violations of liberty means nobody’s liberty has been violated. Or…something.

The public option is gone. Therefore, this bill needs to be killed. Enforcing people to buy insurance, forcing insurance companies to cover higher risk people (pre-existing conditions) etc, would skyrocket our premiums. Either have bill with Public option or other forms of competitive measures, or kill it…

Okay, that was stupid. Let’s see…if we force people to buy private insurance, even those with pre-existing conditions premiums would sky rocket which is an assault on slashingtonguedotcom’s wallet and is just plain wrong. But some how with magical pixie dust the public option would keep costs low.

[...] James Joyner has linked to one of many posts I have written in opposition to mandates. I agree with him that, despite the questions of hypocrisy raised above, this is controversial and is a legitimate objection to Obama’s current policies.Â I disagree with him in citing this one reasonable objection to the current health care reforms as evidence that the general opposition to health care reform has been reasonable. Not only have most (but not all) conservatives been silent about this objection until now, but the vast majority of objections have been absurd. Having some valid objections such as opposition to mandates does not make false claims of “death panel,” “a government take over of health care” and other Republican distortions of what is being proposed any more justifiable. [...]

Where does the government get the authority to force me to indemnify myself against future possible costs? Certainly not in any founding document. No matter how humanitarian, no government should have the power to give you the right to services I provide as I am not entitled to services you provide. A close reading of the Constitution reveals no guarantee to health care. Those wishing a nanny state should move to one and leave those of us who wish to enjoy the liberty this country stands for free to enjoy it without determined effort by the power hungry to infringe on our freedom. You do not know what is best for me and I am ready to fight to the death protect that which I inherited.

As a practical matter, the mandate doesn’t make sense in the Bachus bill because the insurance companies are free to risk rate for age. My eyeball estimate of health insurance premiums over the years is that a man in his 50s has premiums three times those of a man in his 20s. Young people pay premiums related to their actuarial risk of claims. Adding coverage doesn’t increase the pool, unless [drumroll] the government prevents insurers from adjusting premiums on the basis of age.

The House Bill would limit insurance companies charging more than a multiple of 2 based upon age. Under that system, young people would see their premiums increase at a rate beyond their actuarial risk to help cover the higher risk of old farts.

The Bachus Bill limits insurance companies to a multiple of 5, which suggests to me, that the mandates will do nothing to distribute costs beyond actuarial principles.

Well Zelsdorf, if you can’t find anything in the constitution to block it, it comes down to majority rule.

(The constitution is a useful list of what government can’t do, but as we’ve seen over the last century, it is not an exhaustive list of what it can do. How else would we get an FAA? Planes weren’t invented, but now the government controls where they fly.)

Brett, the more I think about using the tax code, the more I wonder about whether doing so would violate the Constitution. If the tax return required one to disclose whether or not one had healthcare insurance, you would be asked to incriminate yourself in a crime.

Now, if the return merely gave you a tax credit for reporting healthcare insurance coverage, then it wouldn’t pose a problem, but that’s really not a mandate.

The law treats automobile ownership as an elective, licensed activity, like plumbing, and therefore the government can condition issuance of any license or registration on meeting certain relevant standards.

Davebo, according to this, roughly 41% of Americans file no tax returns. I assume a lot of these are retired and on Medicare, so they are insured, but that’s still a lot of Americans outside the income tax system to rely upon it as a policing mechanism. Plus, how many people eligible for a $2,000 EITC would file if they had to face a $3,000 penalty for being uninsured?

Brett, the more I think about using the tax code, the more I wonder about whether doing so would violate the Constitution.

Like this is a real problem. Congress has been pretty much ignoring the Constitution for quite some time now, and thanks to the creative interpretation of the Commerce Clause you can pretty much do what you want.

I can’t have been the only one beating the drum about mandates (although it felt like a lonely position at times). It was clear long ago that any plan that imposes them on the American public without first creating significant savings would be a disaster, both politically and in human terms. As things stand now, a family of four without employer coverage trying to get by on $75,000 could suddenly be forced to fork over 20% of their income to a health insurer — or face government punishment.1

And according to the usually-reliable form Martin E. Segal, those costs are likely to rise more than 10% on average in the coming year, even as benefits are cut back. Mandates? To buy that??

Even if healthcare insurance is commerce (I think it is), the government still can’t punish people without complying with a whole bunch of provisions to protect criminals. I found this discussion about taxation of drug income to be interesting because it shows that requiring a person to report illegal drug income can violate due process and the prohibition against double jeopardy and self-incrimination.

I wonder if we will just have a mandate, like state use taxes, that only saints and politicians comply with.

Davebo, according to this, roughly 41% of Americans file no tax returns. I assume a lot of these are retired and on Medicare, so they are insured, but that’s still a lot of Americans outside the income tax system to rely upon it as a policing mechanism. Plus, how many people eligible for a $2,000 EITC would file if they had to face a $3,000 penalty for being uninsured?

Did you actually read your own link? About 15 million households (much less than 41%) don’t file tax returns – they come up with the 41% by combining those with people with no income tax liability (usually because of things like the EITC).

Why should I be a sucker and pay for his hospital bill when he could have bought insurance?

“See, two wrongs do make a right! Or two violations of liberty means nobody’s liberty has been violated. Or…something.”

OK, Mr Verdon, how do we right that second wrong? How do we unviolate your liberty? Let all who refuse to buy insurance but still get in auto accidents die in the street? Let all who refuse to buy insurance but have massive strokes die in their beds? Well?

OK, Mr Verdon, how do we right that second wrong? How do we unviolate your liberty? Let all who refuse to buy insurance but still get in auto accidents die in the street? Let all who refuse to buy insurance but have massive strokes die in their beds? Well?

I never said freedom was easy.

Freedom is something most people no longer want in this country. We want to be pets. Provided for and told what to do (get of the couch, sit, stay lay down) and who knows, maybe if these health care costs get really out of hand sick people can meet the same fate as the sick family dog.

But seriously, so a guy is hurt, dying even. Is that really justification to go and take by force from other people? Most people earn their money by working…selling a little bit of their own life. So you are saying that it is okay to take a little bit of Bob’s life to save Joe’s life.

Think of it this way. If you are going to want to take a part of my life to help people with regards to health care then I want to go through their kitchen, house, and lifestyle and delete everything that is overly risky. I, and everyone else, will approve of the foods you eat, your shower set up, the people you date, and whether or not you can have kids (any genetic issues in your family we should know about?), and so forth.

I’m not really joking all that much. Brad DeLong actually had a serious post on this. His solution to the health care debate was a massive increase in the Nanny State. Do you like to read on the toilet? Stop it, hemoroids. Want to have another glass of wine? Nope, 1 is okay, 2 is not. Want to stay up late and finish that movie? No a good night’s sleep is imperative. Put down that candy bar. Run, shower, don’t forget the sit-ups.

On the plus side we wont have annoying skateboarders anymore. And skiing. Jesus I find people who talk about skiing annoying. Can’t wait till we can ban that.

I am on some level okay with a mandate if the mandate is for a very basic catastrophic type plan. It is when the mandate keeps having the bar raised that I object.

but I am not at all keen on the idea that the agency checking to see if we have insurance is the IRS. There is just something about putting even more power into the hands of the IRS that doesn’t sit well with me. I am also not sure that a Federal mandate isn’t overstepping the bounds of state autonomy IMO, but I do think this is very debatable.

OK, Mr Verdon, how do we right that second wrong? How do we unviolate your liberty?

Easy, put a liberty mandate in the healthcare bill:

2.3

…

(f)(7): The liberty of every American shall be a basic fundamental right.

. . .

(g) The government shall use all powers, needful to the ends of enforcing the aforementioned subparagraphs on all persons, including corporations. Such powers include, where deemed necessary, at the state’s discretion, those of military and police forces, as well as the allotment of compulsory citizenship service. Actions taken in furtherance of this provisions shall not be subject to judicial review and the writ of habeas corpus is deemed abridged regarding all government actions in furtherance of these mandates, or those implied thereby.

Under George Bush we lost our Sixth Amendment and Habeas Corpus rights, with virtually no protest from conservatives. It was OK for the President to have “enemy combatants” imprisoned and held indefinitely on the basis of anonymous accusations and without the assistance of counsel. Torture was allowed because lawyers appointed by the administration said it was legal, and the provisions of the Geneva Convention dealing with interrogation procedures were called “quaint”, again with the complicity of right wingers. Now we come to health insurance reform, and suddenly people like Steve Verdon appeal to our sense of right and wrong. I don’t expect him to have a conscience, but doesn’t he at least have a sense of humor?

So…who among you is in favor of overturning the law that mandates that emergency rooms cannot refuse treatment to anyone because of the inability to pay? Surely that would make freedom a little “easier”…

Freedom is something most people no longer want in this country. We want to be pets. Provided for and told what to do (get of the couch, sit, stay lay down) and who knows, maybe if these health care costs get really out of hand sick people can meet the same fate as the sick family dog.

Somalia’s always looking for skilled labor, Steve. No government, no rules – you get to just live by your wits and gun, as long as you don’t piss off the wrong warlord, that is.

But it’s good to see you’re honest. I always pegged you for a “screw the poor – it’s not my problem” type. Of course, if we’re going to live in that type of society, why should the state take my money to pay for protection of your property rights?

But seriously, so a guy is hurt, dying even. Is that really justification to go and take by force from other people? Most people earn their money by working…selling a little bit of their own life. So you are saying that it is okay to take a little bit of Bob’s life to save Joe’s life.

Sure. Of course, I tend to base my morality on beneficial outcomes, sympathy, and utilitarianism, rather than absolute rights and “I’ve got mine and screw everybody else”.

Think of it this way. If you are going to want to take a part of my life to help people with regards to health care then I want to go through their kitchen, house, and lifestyle and delete everything that is overly risky. I, and everyone else, will approve of the foods you eat, your shower set up, the people you date, and whether or not you can have kids (any genetic issues in your family we should know about?), and so forth.

You’re always free to lobby to do so. Of course, the rest of us might disagree – we tend not to think in False Dilemma and Slippery Slope Fallacies.

I’m not really joking all that much. Brad DeLong actually had a serious post on this. His solution to the health care debate was a massive increase in the Nanny State. Do you like to read on the toilet? Stop it, hemoroids. Want to have another glass of wine? Nope, 1 is okay, 2 is not. Want to stay up late and finish that movie? No a good night’s sleep is imperative. Put down that candy bar. Run, shower, don’t forget the sit-ups.

DeLong’s “massive increase in the nanny state” amounted to the federal government basically setting aside a chunk of the tax you pay into an HSA, with government-provided insurance for everything that exceeds that, along with what amounts to mobile primary care clinics. What I found hilarious was that you went and praised Singapore’s health care system for not being such a “nanny state”, even though it’s more or less the same thing.

What does the right really want? They endlessly bitch about not wanting to pay for someone else’s medical care, then when a remedy is presented that would force people to be responsibility for their own care, liberty is about to come to an end.

Its not a perfect world guys, if you don’t want mandated insurance, quit crying about how others have their hands on your wallet…

[...] this plan or fire back with a new media offensive and round of speeches?Â The campaign version of Obama opposed mandates and the issue has become quite a topic for debate between limo liberals and their blue-collared [...]

What is wrong with everyone? We NEED healthcare reform, the system is totally BROKEN with no end in site for cost increases. Stop it already with the individual rights being trampled on–if you have a social security number you are already part of ‘the system’. I think some, many, just like to bellyache to have something to write on these websites.Everyone nationwide, but especially in Washington, grow up and try, for once, to actually work towards something good for everyone.

Not only do all of the proposed plans mandate health insurance enrollment, they also specify what must be covered. This is the absurdity and ought to be the focus of outrage.

When I buy insurance, I do so to transfer risk. I make a bet with the insurers. And, I get to determine what I am willing to pay for peace of mind.

But all of the current bills mandate specific coverages. I am not interested in insuring against the risk I might need mental health services, or pregnancy, or chiropractic or acupuncture treatments — or any of a host of “benefits” written into these bills (or as may be required by unelected managers down the road).

And, I am more than willing to forgo guarantees that I would be covered for pre-existing conditions provided that I am free to shop for my insurance across state lines — I’m sure that there would be many, many insurers who would take my bets if they were free to do business with me.

And, I would willingly forgo my right to sue for malpractice in return for lower premiums.

And, I would only buy catastrophic coverage — I’m happy to self-insure for the first 5 or 10 thousand dollars of costs in return for vastly lower premiums.

The current bills would deny me all of these options. This is the real scandal.

Now we come to health insurance reform, and suddenly people like Steve Verdon appeal to our sense of right and wrong. I don’t expect him to have a conscience, but doesn’t he at least have a sense of humor?

Stan,

You lost those long before Bush, he just put the final nail in the coffin. You have read my posts on things like SWAT raids, polic abuse, etc. right? You do know I’m a frequent commenter over at the Agitator, and you probably don’t know that I read Charles “Rad Geek” Johnson (no not little green footballs). Once again you demonstrate your ignorance on a billboard. Good job.

Oh, and you not all pegs are round or square. Stop trying to cram me into the wrong hole.

Fog,

Let all who refuse to buy insurance but still get in auto accidents die in the street? Let all who refuse to buy insurance but have massive strokes die in their beds?

“I never said freedom was easy.”

There are no words.

Well, other than you want to be a pet of the govenrment because you are freightened.

Brett,

Somalia’s always looking for skilled labor, Steve. No government, no rules – you get to just live by your wits and gun, as long as you don’t piss off the wrong warlord, that is.

Funny how you liberals always confuse tyranny and chaos for freedom. Maybe this is why it scares you.

But it’s good to see you’re honest. I always pegged you for a “screw the poor – it’s not my problem” type. Of course, if we’re going to live in that type of society, why should the state take my money to pay for protection of your property rights?

I didn’t write this either. Freedom is a scary thing to most people these days. If it means you have to do things for yourself people often find that unsettling because they might not be able to do what needs to be done. So we have, instead, a government that enables people to engage in foolish behavior. We implicitly encourage 16 year old girls to have babies for example.

Sure. Of course, I tend to base my morality on beneficial outcomes, sympathy, and utilitarianism, rather than absolute rights and “I’ve got mine and screw everybody else”.

Utilitarianism is a problematic philosophy. We can’t measure utility (an individuals well being) directly. So where exactly do you stop? Do we let one person die to save 2? How about 3? What about 40? As a side note, maybe you should change the name you use for posting, I’d recommend Adrian Veidt. Sure there might be some bright line cases, but overall its not such a great philosophy for basing government decisions. Especially since it will be the government that decides when you’ve had too much or haven’t had enough. Utilitarian forms of government almost always come down the the “Right Man” in power myth. Look at our previous “Man in Power” was he the right man?

You’re always free to lobby to do so. Of course, the rest of us might disagree – we tend not to think in False Dilemma and Slippery Slope Fallacies.

But sometimes slopes are slippery and we only have two choices. We are already doing some of this stuff, as I’ve noted. Use drugs, no organ transplant for you, even if it is medical marijuana. Baby born to early, its left to die. Smokers in the U.K.? Denied various treatments until they quit.

DeLong’s “massive increase in the nanny state” amounted to the federal government basically setting aside a chunk of the tax you pay into an HSA, with government-provided insurance for everything that exceeds that, along with what amounts to mobile primary care clinics. What I found hilarious was that you went and praised Singapore’s health care system for not being such a “nanny state”, even though it’s more or less the same thing.

Uhhhmmm, no. DeLong was pretty clear, he favored in increase in the government telling what you can and cannot do. To be fair DeLong suggested something a massive propaganda campaign via the television, but I don’t think that would be sufficient. And I’m not thrilled with the Singaporean Nanny State. And while Singapore’s health care system appears to be sustainable I think one factor might be the really small population. Not exactly a ringing endorsement.

Pam,

What is wrong with everyone? We NEED healthcare reform, the system is totally BROKEN with no end in site for cost increases.

Yes, I’ve said as much many, many times. But look the people who are putting together the health care reform legislation are doing ABSOLUTELY NOTHING about costs. In fact, the bills before Congress will INCREASE costs. What the Republicans have done is a good thing. It has stopped bad bills from becoming law.

Freedom is a scary thing to most people these days. If it means you have to do things for yourself people often find that unsettling because they might not be able to do what needs to be done.

So, Captain Freedom, tell us what happens if, God forbid, you have a catastrophic accident tomorrow. It happens all the time you know. You wake up in the hospital, and you are a quadriplegic. You need constant nursing care. You can’t work. Your home needs to be retrofitted. Bills are pouring in. Guess what, you are a charity case, and you probably will be one for the rest of your life. Will you turn down and government assistance because you value “freedom” so highly?

Who is a free rider? The person who is uninsured and pays for every cent of every medical bill out of his own pocket? OR: The one with pre existing conditions who insists on paying $3000/yr in premiums and getting $12,000 /yr in medical care
(insulin, drugs, weekly visits to the doctor, treatment center)

The healthy uninsureds in this country who pay their own bills have not cost society one red cent. Until we do, shut the &^%$ up!